Pituitary gland protocol (MRI)

MRI protocol for pituitary gland is a group of MRI sequences put together to improve sensitivity and specificity for the assessment of lesions of the pituitary gland (e.g. pituitary adenoma) and other sellar and suprasellar abnormalities (check the article on pituitary region masses for some examples). 

MRI is nowadays the imaging procedure of choice for the pituitary gland assessment, largely replacing CT, which is currently reserved to the assessment of bone destruction and surgically relevant bone anatomy 1.

For how to have a systematic approach to the pituitary region, please refer to the article on pituitary MRI (an approach).

Note: This article is intended to outline some general principles of protocol design. The specifics will vary depending on MRI hardware and software, radiologist's and referrer's preference, institutional protocols, patient factors (e.g. allergy) and time constraints. 

Sequences

The sequences for this purpose should be performed with small FOV targeting the sella. A good protocol for this purpose involves at least:

  • T1
  • T2
    • sequence: axial with high resolution/thin slices 
    • purpose: 
  • T1 C+ (Gd)
    • sequence: small FOV coronal dynamic enhancement and routine small FOV coronal and sagittal
    • purpose: 
      • dynamic: useful to identify microadenomas, to assess the invasion of cavernous sinus by macroadenomas, and to help distinguish between residual or recurrent tumour from postoperative tissues 1
      • routine post contrast: valuable to assess the cavernous sinuses and to characterise other sellar region tumours
    • Gadolinium-based contrast agents (GBCAs) for CNS 2:
    • all these GBCAs are approved by FDA at identical administered total doses of 0.1mmol/kg body weight 2
MRI protocols
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Article information

rID: 50127
Synonyms or Alternate Spellings:
  • MRI protocol for assessing the sellar region
  • Sellar region MRI protocol

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